This section addresses waste reduction for healthcare facility solid wastes. For the purpose of this discussion, solid waste refers to what we think of as “municipal waste” and does not include hazardous or regulated medical wastes.

WasteWise is a voluntary EPA program through which organizations eliminate costly solid waste, benefiting their bottom line and the environment.

Characterizing the solid waste stream

The origin and character of solid wastes generated at healthcare facilities varies widely, depending on the type of facility (i.e., hospitals, laboratory, dental office, etc.). For example, hospitals generate most of their solid waste as a consequence of patient care, while laboratory solid waste consists more of packaging from purchased chemicals and equipment. Although the majority of the information in this section relates directly to hospital solid waste, the information for certain departments, such as purchasing, offices, and custodial services is applicable to nearly all healthcare facilities.

For most hospitals the largest components of the solid waste stream are paper (especially cardboard, mixed paper, newspapers, and high-grade paper), food waste, and disposable linens (a combination of paper and other materials), plastics (especially film plastic) diapers, and glass. Yard trimmings may also be a significant percentage of the waste stream if a hospital has a large landscaped area.

A survey of nine California hospitals in 1990 showed the following average breakdown of solid wastes:

paper – 53.8%

food and other organics – 17.5%

plastic – 14.6%

diapers – 3.5%

glass – 1.8%

yard trimmings – 1.6%

other – 4.5%

Solid waste quantity depends heavily on the size of the facility and for hospitals is often expressed as pounds per bed-year. Another California study indicated that hospitals might be expected to generate 16 pounds per bed-day, or 5,840 pounds per bed-year. More recently, hospitals have demonstrated that they can do significantly better than that -- one facility with over 350 staffed beds reported just over 10 pounds per bed-day, or less than 4,000 per bed-year. Smaller facilities generally find it harder to meet similar targets, but improvements can result in significant savings, and are typically well worth the effort.

Setting goals for solid waste reduction

Short of eliminating patients, visitors and staff, healthcare facilities are going to generate solid waste -- no matter how much effort is put into waste prevention and recycling, there will be a residual quantity that cannot be eliminated. Therefore, a good question is: how high to set the bar? The answer depends on many factors, some of which you can affect (like levels of enthusiasm), and others that you will have less control over. Here are some factors to consider when setting goals:

Starting point -- What existing waste reduction programs are in effect? If you are starting at square one, then expect major reductions. If you already have successful prevention or recycle programs in place, it will be harder to achieve a high percentage reduction in the future.

Budget -- Solid waste reduction will save money, but some expenditure must be expected – as the old saying goes, “to make money you have to spend money.”

Availability of markets for recyclables – All areas of the U.S. have markets for paper, glass and plastic, but other wastes, such as used carpeting, furniture or office equipment, may be difficult to recycle in certain locales.

Local laws and ordinances may impede some recycling activities (e.g., composting of cafeteria wastes).

Keeping in mind that there is bound to be some significant case-to-case variability, it is possible to roughly estimate your potential success by looking at case studies that document the achievements of other healthcare facilities. Below, you will find links to documents that describe real life success stories.

Solid waste reduction methods

Solid waste reduction methods, including prevention and recycling schemes, are listed below by department along with some applicable references and case studies. To be successful and sustainable, as with any program, solid waste reduction must be implemented in an organized and systematic way. The program must involve management, purchasing, and staff in various departments.

Set up system where nursing staff evaluate personal care items such as aspirin packets, tissues, shampoo, baby wipes and diapers for reuse (following infection control guidelines) instead of automatically disposing them

Sparrow Health System (Lansing, MI) donated a 40-foot semi-trailer full of medical supplies, medical equipment, beds, furniture, and computers to Ghana, Africa through a local “sisters cities” program.

Recycle glass, cans, cardboard, plastics, and paper, whenever possible. Keep food waste out of containers you want to recycle. Avoid throwing away items that can be reused. Recycle kitchen greases—don’t throw them into garbage, septic, sewer, or down the drain.

Keep area clean and free of unnecessary items and food debris that will attract unwanted pests. Reduce the use of chemical pesticides and seek non-chemical or less-toxic products and methods for pest control.